Labor's Edge: Views from the California Labor Movement

The Fiscal Cliff Can’t Be Solved by Throwing Seniors Over the Cliff

I want to vote for a comprehensive bipartisan plan to address the fiscal cliff. I’m willing to take a tough vote. I’m willing to make sacrifices. I’m willing to feel the heat. But I’m not willing to solve the fiscal cliff by throwing seniors over the cliff. I draw the line at cutting benefits in Medicare and Social Security.

This week, House Republicans unveiled their fiscal cliff counterproposal. While they continue to call for an extension of the Bush tax cuts for millionaires and billionaires, they propose offsetting this cost by gutting Medicare benefits, including raising the age of Medicare eligibility to 67. I won’t go there. As California’s Insurance Commissioner for eight years, I know this would be horrible policy, throwing millions of seniors into the rapacious hands of an insurance industry interested only in profits for its shareholders.

Medicare is a promise we made to seniors more than four decades ago. When President Johnson signed Medicare into law, one in three seniors lived in poverty. Half of seniors had no health coverage at all. Today, less than one in ten seniors live in poverty and almost all have guaranteed access to affordable coverage. With medical expenses as high as they are, that’s a remarkable improvement, and we have Medicare and Social Security principally to thank for it.

The seniors being kicked off Medicare under the GOP plan will face uncertainty, delayed treatments, and more expensive care – if they can even afford health care at all. Do we really want our emergency rooms clogged with seniors who couldn’t afford their heart medication and suffer a preventable heart attack? Is it really in anyone’s interest to see grandmothers and grandfathers sent to an early grave because they were forced to choose between having a roof over their head or paying out of pocket for lifesaving diabetes medication? This is, to borrow a phrase from Mitt Romney, severe conservatism, and it’s the opposite of a reasonable bipartisan fact-based compromise.

If the House Republican plan to increase the age of Medicare eligibility to 67 moves forward, health care delivery in America would become more expensive for everyone. Seniors remaining on Medicare would see a substantial increase in their premiums because seniors ages 65 and 66, in the aggregate, are a lot healthier than seniors 67 and above. By moving 65 and 66 year olds into the expensive private market, states, local governments, employers, and the general public would pick up the multi-billion dollar tab. For example, businesses who provide health insurance and have older workers would bear the full cost of health insurance – effectively shifting the cost to these employers and their employees.

If the goal is to keep the Medicare system running as efficiently as possible, we should be looking into ways to lower the age of Medicare eligibility, not ways to increase it. The Republican plan chips away at Medicare affordability – one of its greatest strengths – seemingly by design. I’m willing to compromise, but I’m not willing to compromise the health and economic security of seniors and everyone who hopes to become a senior.

I approach this from the perspective of someone who regulated the insurance industry for eight years. I know how they operate, and I know how health care delivery operates in America. I know changes need to be made to Medicare to make it more solvent in the years and decades to come, and I know we can make those changes without harming benefits. For example, we can empower Medicare to directly negotiate drug prices or we can import drugs from Canada and other countries with robust safety standards. We can improve electronic records and crack down further on Medicare fraud. We can ramp up the prevention and early treatment provisions in current law. Each of these ideas has support among most Democrats and many Republicans. Let’s make these ideas the starting point in extending the solvency of Medicare (beyond the eight additional years from the Affordable Care Act) and in preventing our national debt from becoming unmanageable in the long-term (as was done under President Clinton).

Compromise to address the fiscal cliff is not an end; it is a means to an end: preserving the health and well being of all Americans. We can fashion a bipartisan deal that keeps seniors’ retirement security preserved. We can take a step back from the fiscal cliff without breaking our promise to seniors.

We can get this done and done right, but raising the age of Medicare eligibility to 67 is a nonstarter for me, and it’s a nonstarter for many of my Democratic colleagues.